Agentes patogênicos e fatores de risco para infecções relacionadas à assistência à saúde em ambiente hospitalar: revisão integrativa da literatura.

Abstract

Objective: To identify in the literature the most frequent pathogenic agents and the main risk factors for Healthcare Related Infections (HAIs) in the hospital environment. Method: This is an integrative review prepared according to PRISMA recommendations and developed after completing six stages: identification of the theme and selection of the research question for the elaboration of the integrative review; establishment of criteria for inclusion and exclusion of studies/sampling or literature search; definition of information to be extracted from selected studies/categorization of studies; evaluation of studies included in the integrative review; interpretation of the results and presentation of the knowledge review/synthesis. The following guiding question was elaborated: What are the main pathogenic agents and risk factors for Health Care-Related Infections in the hospital environment? The search was carried out in the PubMed Central, Web of Science, LILACS and Scorpus databases, covering the period from May to June 2023. For the search for articles, controlled descriptors were selected, after consulting the vocabularies in the Health Sciences Descriptors (DeSC) and Medical Subject Headings (MESH), “patient care team”, “hospitalized patients”, “hospital infection”, “hospital care” and “hospitalization”, in English and Portuguese. The time interval from 2018 to 2023 was used, and articles that did not respond to the guiding question were excluded. 1,480 articles were identified. The sample consisted of eighteen articles. Results: The main microorganisms associated with the etiology of HAIs are Pseudomonas aeruginosa (55.6%), methicillin-resistant Staphylococcus aureus (44.5%), Klebsiella pneumoniae (38.9%), Acinetobacter baumannii (33.3%) and Clostridioides difficile (27.8%). The main risk factors identified were: comorbidities (72.2%); multiple invasive procedures (66.7%); admission to the ICU (55.6%); prolonged hospital stay (55.6%) and misuse or inappropriate use of antimicrobials (50%). Conclusion: The microorganisms most frequently associated with ARIs were bacteria, although most of the time non-pathogenic they are able to quickly overcome the low resistance of immunosuppressed patients causing infectious diseases. HAI may have risk factors related to the individual, previous health conditions and the assistance of health professionals. The identification of microorganisms most frequently related to HAI helps in choosing the appropriate antimicrobial therapy, as well as knowledge of risk factors for these adverse events is important for identifying more vulnerable subgroups. Thus, the implementation of permanent health education actions on the subject is essential, in addition to the need to implement protocols with preventive measures for HAI and the improvement of biosafety practices in the hospital environment are fundamental to reduce the incidence of these infections, guaranteeing quality in patient care and safety.